The Coming Dental Practice Succession Wave: Who Will Own America’s Dental Offices Next?

There is a remarkable divide hiding inside the American dental industry.

Among dentists under age 30, only 8.8% own a practice.

Among dentists ages 55 to 64, that figure rises to 89.7%.

And among dentists age 65 and older, 93.4% are practice owners.

Those American Dental Association figures do not mean that 93.4% of dental practice owners are 65 or older. They measure something different: the percentage of dentists within each age group who own a practice.

But the contrast is still striking.

The generations of dentists closest to traditional retirement age have extraordinarily high rates of practice ownership, while the youngest dentists are far less likely to own.

That raises an important question for the future of American dentistry:

What happens to established dental practices when today’s older practice owners eventually decide to retire?

Some practices will pass to younger dentists. Others may be acquired by larger dental groups. Partners may buy out retiring colleagues. Some dentists may sell to associates already working inside their practices.

And some practices may simply disappear.

The coming transition could influence who owns America’s dental offices, how younger dentists become entrepreneurs, and whether independent dental practice ownership remains as common for the next generation as it was for the last.

Dental Practice Ownership Rises Dramatically With Age

Dental practice ownership has historically been closely associated with career stage.

According to data from the American Dental Association, practice ownership rates rise dramatically as dentists get older.

The contrast between the youngest and oldest groups is particularly notable:

• 8.8% of dentists under 30 own a practice
• 89.7% of dentists ages 55–64 own a practice
• 93.4% of dentists age 65 or older own a practice

These figures need to be interpreted carefully.

They do not show the percentage of all dental practice owners who fall within each age bracket.

Instead, they show how common practice ownership is among dentists of different ages.

Still, they reveal an important generational difference.

For many older dentists, becoming a practice owner was a major part of the traditional professional path.

For younger dentists, ownership may come much later—or potentially take a different form altogether.

What Happens When a Generation of Dental Practice Owners Retires?

A dentist doesn’t automatically retire at 65.

Some practice owners work well beyond traditional retirement age. Others sell earlier. Some gradually reduce their schedules while bringing in associates or partners.

There will not be one moment when America’s older dentists suddenly leave dentistry.

But retirement is ultimately unavoidable.

And because practice ownership rates are so high among older dentists, succession deserves serious attention.

Every established dental practice eventually faces some version of the same question:

Who takes over when the owner is ready to stop practicing?

The answer matters because a dental practice represents far more than an office filled with dental equipment.

A Dental Practice Can Take Decades to Build

Imagine a dentist who opened an independent office 30 years ago.

At the beginning, the practice may have had relatively few patients.

Over time, that dentist built a patient base.

Families referred other families.

Children who first entered the office as young patients eventually became adults.

Employees were hired and trained.

Hygiene schedules were developed.

Referral relationships were established.

Technology and equipment were purchased.

A reputation developed in the community.

By the time the dentist reaches retirement, the practice may represent decades of accumulated value.

That value can include:

• An established patient base
• Recurring hygiene appointments
• Experienced employees
• Dental equipment
• Office systems and technology
• Referral relationships
• Location and leasehold improvements
• Brand recognition
• Community reputation
• Historical financial performance
• Goodwill

Some of those assets are tangible.

Others depend heavily on trust.

A retiring dentist therefore isn’t simply deciding what to do with dental chairs and equipment.

The owner may be deciding what happens to relationships built over an entire career.

Dental Practice Succession Is About Continuity

For patients, ownership succession may be nearly invisible when it is handled well.

The office can remain in the same location.

The hygienists may remain.

The phone number may stay the same.

Patients may continue following familiar appointment schedules.

The most significant change could simply be the dentist providing their care.

Behind the scenes, however, the transition can be substantial.

A buyer needs to understand the practice.

Employees need confidence in the new owner.

Patients need to feel comfortable.

The retiring dentist may need to introduce the successor.

Systems and responsibilities need to transfer.

Financial obligations need to be understood.

A successful dental practice transition therefore involves more than signing a purchase agreement.

It involves transferring trust.

The Next Generation of Dentists Has a Major Decision to Make

For younger dentists, the changing ownership landscape presents an important career choice.

They can remain employees or associates.

They can start practices from scratch.

They can become partners.

They can buy existing practices.

Or they can work within larger dental organizations.

Each path offers different benefits and risks.

For dentists who want ownership, however, the retirement of established practice owners could create significant opportunities.

Rather than spending years building a patient base from zero, a younger dentist may be able to acquire an existing operation.

That doesn’t make the transition easy.

But it changes the entrepreneurial equation.

Starting a Dental Practice Versus Buying an Existing Practice

Starting from scratch can provide enormous freedom.

The dentist can choose the location, design the office, select technology, build the team, develop the brand, and create the culture.

But starting from zero also means exactly that:

zero.

There may initially be no established patient base.

No recurring hygiene schedule.

No local reputation.

No experienced team.

No historical practice revenue.

No referral network.

Buying an existing dental practice presents a very different proposition.

Depending on the practice, a buyer may acquire an operating business with patients, employees, equipment, systems, and existing revenue.

But the buyer may also inherit problems.

Equipment could be outdated.

The lease may be unfavorable.

The practice may depend too heavily on the selling dentist.

Patient retention may be uncertain.

Employees may leave after the transition.

Financial performance may not be as strong as it initially appears.

Buying an established practice is therefore not automatically better than starting one.

It is a different kind of entrepreneurial risk.

The Associate-to-Owner Path Could Become Increasingly Important

One of the most natural succession models may already exist inside many dental offices.

A practice owner brings in a younger associate.

The associate works alongside the owner.

Patients become familiar with the younger dentist.

Employees develop relationships with both dentists.

The associate learns how the practice operates.

Over time, the associate may buy part of the practice, become a partner, or eventually purchase the entire business.

For the retiring dentist, this approach can offer continuity.

For the younger dentist, it can provide a gradual path into ownership.

For patients and employees, it can make the transition less abrupt.

The person buying the business isn’t a stranger.

They may already be part of it.

Dental Practice Ownership Also Has a Gender Gap

Age isn’t the only demographic difference in dental practice ownership.

ADA data also shows a substantial ownership-rate gap between male and female dentists.

Approximately 79.9% of male dentists own practices, compared with 59.9% of female dentists.

That is a difference of 20 percentage points.

Again, the statistic should be interpreted as an ownership rate within each group rather than a complete demographic profile of all dental practice owners.

But the difference raises another important question about dentistry’s future:

Will the ownership gap narrow as the profession changes?

The answer could have significant implications for who owns dental practices in the decades ahead.

The next generation of practice ownership may not simply be younger.

It could also become more diverse.

Independent Ownership Isn’t the Only Possible Future

There is another major force shaping dental practice succession:

consolidation.

A retiring dentist doesn’t necessarily have to sell the practice to another individual dentist.

Larger dental groups and dental support organizations can also participate in practice acquisitions and consolidation.

For some owners, that may provide an attractive exit opportunity.

For some dentists, larger organizations can provide administrative support, purchasing scale, technology, marketing, recruiting, and other resources.

For others, independent practice ownership remains attractive because of the autonomy it can provide.

The future of dentistry is therefore unlikely to be entirely independent or entirely consolidated.

Both models can coexist.

But succession decisions made by today’s older practice owners could influence the balance between them.

What Happens If Younger Dentists Don’t Buy the Practices?

Consider what happens when an older dentist wants to retire but no younger dentist wants—or is able—to purchase the practice.

Several outcomes are possible.

A larger organization may acquire it.

Another local dentist may purchase the patient records or certain assets.

The practice may merge with another office.

Or the office may eventually close.

That can affect more than the retiring dentist.

Employees may need new jobs.

Patients may need new providers.

Longstanding referral relationships may end.

The community can lose an independently owned business.

The issue becomes particularly significant in communities where there are fewer dental providers or fewer potential buyers.

Succession is therefore not simply a retirement-planning issue.

It can become a business-continuity issue.

Why Some Younger Dentists May Wait Longer to Become Owners

The dramatic difference in ownership rates by age doesn’t necessarily mean younger dentists don’t want ownership.

Age itself is an important factor.

A dentist under 30 may have only recently completed dental school and entered practice.

Ownership may simply come later.

There are also substantial economic and professional considerations involved in becoming an owner.

A dentist considering ownership may have to evaluate:

• Practice acquisition costs
• Student debt
• Equipment expenses
• Real estate or lease obligations
• Payroll
• Insurance
• Technology
• Staffing
• Marketing
• Billing and collections
• Regulatory responsibilities
• Working-capital requirements

Clinical expertise and business ownership are also different skills.

A dentist can be exceptional at dentistry without having experience managing employees, analyzing financial statements, negotiating leases, marketing a business, or managing cash flow.

Becoming an owner often means becoming a CEO at the same time.

The Business Education Gap Matters

Dental school teaches dentists how to practice dentistry.

Running a dental practice requires an additional set of capabilities.

An owner may need to understand:

• Hiring
• Compensation
• Scheduling
• Financial management
• Marketing
• Patient acquisition
• Employee retention
• Insurance relationships
• Vendor negotiations
• Technology investments
• Compliance
• Leadership
• Business strategy

For a younger dentist buying a practice, the transition can therefore involve two major changes simultaneously:

Becoming the primary clinical decision-maker and becoming the owner of a business.

That makes preparation particularly important.

The strongest succession plans may begin well before the seller’s final day in the office.

Buying a Dental Practice Is Only the First Capital Requirement

When people think about acquiring a dental practice, they naturally focus on the purchase price.

But the transaction is only the beginning.

The new owner may quickly discover additional needs.

Perhaps the imaging equipment needs to be upgraded.

The office needs renovation.

A new hygienist needs to be hired.

The website and marketing strategy need modernization.

Additional operatories could increase capacity.

Technology needs updating.

Payroll still has to be met.

Supplies still need to be purchased.

Unexpected expenses can occur immediately after ownership changes.

That means a dentist considering an acquisition needs to ask two separate financial questions:

How will I acquire the practice?

And:

How will I fund the business after I own it?

The second question can be just as important as the first.

Working Capital Can Matter Even in a Profitable Dental Practice

Profitability does not mean a business never experiences cash-flow pressure.

Dental practices have ongoing expenses.

Employees need to be paid.

Rent is due.

Supplies must be purchased.

Equipment can fail.

Marketing expenses occur before new patients generate revenue.

Expansion requires spending before additional capacity produces results.

Insurance reimbursements and patient collections may not always align perfectly with the timing of expenses.

A growing practice can therefore need additional working capital precisely because it is growing.

The same is true after an ownership transition.

A buyer may inherit a profitable operation but still need liquidity to execute plans for the business.

Technology Could Accelerate the Dental Ownership Transition

A practice that has operated successfully for decades may not necessarily have the technology a younger owner wants.

A new owner may see opportunities to invest in:

• Digital imaging
• Practice-management software
• Patient communication systems
• Online scheduling
• New dental equipment
• Cybersecurity
• Digital marketing
• Office renovations
• Additional treatment capacity

These investments can help modernize an established practice.

They also require capital.

This creates an interesting opportunity within succession.

The next owner doesn’t necessarily have to preserve the business exactly as it existed.

The buyer can inherit the practice’s foundation and then build something new on top of it.

What Retiring Dental Practice Owners Should Consider

A dentist doesn’t need to wait until the final year of practice to think about succession.

Planning earlier can create more options.

Determine How Dependent the Practice Is on You

If nearly every patient relationship depends personally on the owner, transferring goodwill may be more difficult.

Introducing associates and developing a broader practice identity can potentially help create continuity.

Maintain Organized Financial Records

Potential buyers need to understand revenue, expenses, profitability, assets, liabilities, patient activity, and other aspects of the business.

Reliable records make evaluation easier.

Think About Employees

A dental practice’s staff can be one of its most important assets.

Employee retention during a transition may help preserve patient relationships and operational continuity.

Identify Potential Successors Early

A successor could be an associate, partner, family member, local dentist, or outside buyer.

Knowing the possibilities can help an owner prepare for them.

Understand What Creates Practice Value

Equipment alone doesn’t define the value of a dental practice.

Patient relationships, recurring appointments, profitability, staff, location, reputation, systems, and goodwill can all matter.

Qualified legal, financial, tax, and valuation professionals should be involved when appropriate.

What Prospective Dental Practice Buyers Should Evaluate

Buying a practice should involve substantial due diligence.

Potential buyers may want to evaluate:

• Historical financial statements
• Tax returns
• Patient counts
• Patient retention
• New-patient trends
• Hygiene production
• Procedure mix
• Insurance participation
• Accounts receivable
• Employee compensation
• Equipment condition
• Lease terms
• Real estate
• Technology
• Regulatory issues
• Seller dependence
• Competition
• Working-capital requirements

A practice with impressive revenue can still have weaknesses.

Conversely, an established practice that needs modernization may present an opportunity for the right buyer.

The goal isn’t simply to buy a dental office.

It is to understand the business being acquired.

Could Practice Acquisition Become a Bigger Part of Dental Entrepreneurship?

For younger dentists who want ownership, acquiring an existing practice may become an increasingly important path.

There is something uniquely powerful about the model.

One generation spends decades building the practice.

Another generation brings new energy, technology, ideas, and ambition.

Instead of allowing decades of business value to disappear when an owner retires, succession allows it to continue.

That can benefit sellers.

It can benefit buyers.

It can benefit employees.

And when transitions are handled effectively, patients can benefit from continuity.

The next great dental entrepreneur may therefore not be someone who opens an office from scratch.

It may be the associate who takes over the practice down the hall.

What Will the Dental Practice of 2035 Look Like?

No single dataset can tell us exactly what dental ownership will look like a decade from now.

Independent practices will continue to exist.

Dental groups will continue to grow.

Some younger dentists will become owners early.

Others will prefer employment.

Some practices will pass between generations.

Others will consolidate.

What we can say is that today’s ownership rates reveal a significant generational divide.

Ownership is extremely common among older dentists and dramatically less common among the youngest dentists.

As older practice owners eventually retire, those businesses will need somewhere to go.

That makes succession one of the most important long-term questions facing dental entrepreneurship.

The central issue isn’t simply:

When will today’s dental practice owners retire?

It is:

Who will own their practices when they do?

The answer could help determine whether the independent dental practice remains a defining part of American dentistry for another generation.

Business Funding for Established Dental Practices

Ownership transitions are only one reason an established dental practice may need additional capital.

Dentists may seek business funding for equipment, technology, renovations, staffing, marketing, expansion, working capital, or time-sensitive business opportunities.

Smart Business Funding works with established businesses across healthcare and other industries, with funding options of up to $5 million per transaction.

With approximately 11 years in business, Smart Business Funding focuses on helping established companies access capital efficiently—including businesses that may not fit neatly within traditional funding requirements.

Explore business funding options for your dental practice with Smart Business Funding.

Funding is subject to approval and applicable terms. Smart Business Funding does not provide legal, tax, valuation, or practice-acquisition advice. Dentists considering the purchase or sale of a practice should consult qualified professional advisors.

Sources and Methodology

Practice ownership statistics in this article are based on data published by the American Dental Association (ADA).

An important distinction applies to the age data cited throughout this article.

Figures such as 8.8% for dentists under 30, 89.7% for dentists ages 55–64, and 93.4% for dentists age 65 and older represent practice ownership rates within those respective age groups.

They do not represent the percentage distribution of dental practice owners by age.

Likewise, the male and female ownership figures cited in this article represent ownership rates within those groups rather than the gender composition of all dental practice owners.

The discussion of future succession is analysis of the implications of current ownership patterns. It should not be interpreted as a projection that a specific number of dental practices will be sold, closed, consolidated, or transferred within a particular period.